CMS Approves Genuine Health Group’s Application To Participate In Direct Contracting Payment Model
MIAMI, FL – November 23, 2020 – Genuine Health Group, the rapidly growing Miami-based healthcare company that partners with primary care physicians to deliver
value-based care, has received approval from the Centers for Medicare & Medicaid Services to launch a Direct Contracting Entity, which will be called Genuine Health Direct. The Direct Contracting payment model is the newest innovation from CMS to help
drive down healthcare expenditures while simultaneously improving health outcomes and increasing health options for Medicare beneficiaries. Direct Contracting Entities (DCEs) must be willing to cover a percentage of healthcare costs – or take on risk – for the
population of Medicare patients they care for.
Genuine Health Group already has a long history of managing risk, both through its Accountable Care Organization and through its agreements with Medicare Advantage Plans. In both instances, the company uses advanced technology to better identify
patients requiring care management that includes home visits, more frequent doctor appointments, and follow-up care after hospitalizations. By using these approaches, Genuine and its physicians have been able to prevent unnecessary hospitalization,
reduce readmissions, and improve care quality. Now, with the launch of Genuine Health Direct, the company will apply these same proven techniques, but with the financial benefit of monthly, prospective payments for the patients whose care they manage.
“CMS approved Genuine Health Direct as a global model Direct Contracting Entity,” said Joe Caruncho, CEO of Genuine Health Group. “This means we earn 100% of the savings we deliver to Medicare and are at risk for any losses. It also means – for the very first time – we’ll be able to pay our participating physicians a capitated payment every month for their Medicare fee-for-service patients. In the past, monthly capitation payments were only available for managed care plans.”
Doctors saw as much as an 80% reduction in revenue for traditional, fee-for-service Medicare patients during the first months of the pandemic. By contrast, for their patients enrolled in Medicare Advantage plans, revenue was constant.
“Primary care physicians experienced unsettling volatility this year,” said Gamil Kharfan, chief growth officer at Genuine Health Group. “We anticipate our new Direct Contracting Entity will be very attractive to doctors seeking more reliable monthly income and who want to deliver high-quality patient care, including the kind of choice that fee-for-service Medicare offers beneficiaries.
It has the potential to be a game changer for physicians and their patients.” The company, which already has more than 200 doctors in its network, is currently recruiting more high-performing primary care physicians for Genuine Health Direct.
For more information about Genuine Health Group and Genuine Health Direct, or to schedule an interview, please contact Meieli Sawyer at 305.668.0070 or msawyer@weinbachgroup.com.
About Genuine Health Group
Genuine Health Group is an analytics-driven healthcare company that assists physicians and health plans in successfully transitioning to value-based payment models.
The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.